Search results for: Barangay health workers

Authors: Paolo Lenzuni

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Cost-effectiveness of noise abatement treatments at the workplace has not yet received adequate consideration. Furthermore, most of the published work is focused on productivity, despite the poor correlation of this quantity with noise levels. There is currently no tool to estimate the social benefit associated to a specific noise abatement treatment, and no comparison among different options is accordingly possible. In this paper, we present an algorithm which has been developed to predict the cost-effectiveness of any planned noise control treatment in a workplace. This algorithm is based the estimates of hearing threshold shifts included in ISO 1999, and on compensations that workers are entitled to once their work-related hearing impairments have been certified. The benefits of a noise abatement treatment are estimated by means of the lower compensation costs which are paid to the impaired workers. Although such benefits have no real meaning in strictly monetary terms, they allow a reliable comparison between different treatments, since actual social costs can be assumed to be proportional to compensation costs. The existing European legislation on occupational exposure to noise it mandates that the noise exposure level be reduced below the upper action limit (85 dBA). There is accordingly little or no motivation for employers to sustain the extra costs required to lower the noise exposure below the lower action limit (80 dBA). In order to make this goal more appealing for employers, the algorithm proposed in this work also includes an ad-hoc element that promotes actions which bring the noise exposure down below 80 dBA. The algorithm has a twofold potential: 1) it can be used as a quality index to promote cost-effective practices; 2) it can be added to the existing criteria used by workers’ compensation authorities to evaluate the cost-effectiveness of technical actions, and support dedicated employers.

Keywords: cost-effectiveness, noise, occupational exposure, treatment

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Authors: Katherine Denise Queri

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The effects of sick workers have an impact in administration of labor. This study aims to provide knowledge on the disease that is Alzheimer’s while presenting an answer to the research question of when and how is the disease considered as a disaster inside the workplace. The study has the following as its research objectives: 1. Define Alzheimer’s disease, 2. Evaluate the effects and consequences of an employee suffering from Alzheimer’s disease, 3. Determine the concept of organizational effectiveness in the area of Human Resources, and 4. Identify common figures associated with Alzheimer’s disease. The researcher gathered important data from books, video presentations, and interviews of workers suffering from Alzheimer’s disease and from the internet. After using all the relevant data collection instruments mentioned, the following data emerged: 1. Alzheimer’s disease has certain consequences inside the workplace, 2. The occurrence of Alzheimer’s Disease in an employee’s life greatly affects the company where the worker is employed, and 3. The concept of workplace efficiency suggests that an employer must prepare for such disasters that Alzheimer’s disease may bring to the company where one is employed. Alzheimer’s disease can present disaster in any workplace.

Keywords: administration, Alzheimer's disease, conflict, disaster, employment

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Authors: Moshreka Aditi Huq

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This study shows how a progressive portion of civil intellectuals in Bangladesh contributed as the solidarity activist entities in a movement of tea workers that became the symbol of their unique moral struggle. Their passive yet sharp way of resistance, with the integration of mass tea workers of a tea estate, got demonstrated against certain private companies and government officials who approached to establish a special economic zone inside the tea garden without offering any compensation and rehabilitation for poor tea workers. Due to massive protests and rebellion, the authorized entrepreneurs had to step back and called off the project immediately. The extraordinary features of this movement generated itself from the deep core social need of indigenous tea workers who are still imprisoned in the colonial cage. Following an anthropological and ethnographic perspective, this study adopted the main three techniques of intensive interview, focus group discussion, and laborious observation, to extract empirical data. The intensive interviews were undertaken informally using a mostly conversational approach. Focus group discussions were piloted among various representative groups where observations prevailed as part of the regular documentation process. These were conducted among civil intellectual entities, tea workers, tea estate authorities, civil service authorities, and business officials to obtain a holistic view of the situation. The fieldwork was executed in capital Dhaka city, along with northern areas like Chandpur-Begumkhan Tea Estate of Chunarughat Upazilla and Habiganj city of Habiganj District of Bangladesh. Correspondingly, secondary data were accessed through books, scholarly papers, archives, newspapers, reports, leaflets, posters, writing blog, and electronic pages of social media. The study results find that: (1) civil intellectuals opposed state-sponsored business impositions by producing counter-discourse and struggled against state hegemony through the phases of the movement; (2) instead of having the active physical resistance, civil intellectuals’ strength was preferably in passive form which was portrayed through their intellectual labor; (3) the combined movement of tea workers and civil intellectuals reflected on social security of ethnic worker communities that contrasts state’s pseudo-development motives which ultimately supports offensive and oppressive neoliberal growths of economy; (4) civil intellectuals are revealed as having certain functional limitations in the process of movement organization as well as resource mobilization; (5) in specific contexts, the genuine need of protest by indigenous subaltern can overshadow intellectual elitism and helps to raise the voices of ‘subjugated knowledge’. This study is quite likely to represent two sets of apparent protagonist entities in the discussion of social injustice and oppressive development intervention. On the one, hand it may help us to find the basic functional characteristics of civil intellectuals in Bangladesh when they are in a passive mode of resistance in social movement issues. On the other hand, it represents the community ownership and inherent protest tendencies of indigenous workers when they feel threatened and insecure. The study seems to have the potential to understand the conditions of ‘subjugated knowledge’ of subalterns. Furthermore, being the memory and narratives, these ‘activism mechanisms’ of social entities broadens the path to understand ‘power’ and ‘resistance’ in more fascinating ways.

Keywords: civil intellectuals, resistance, subjugated knowledge, indigenous

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Authors: Nirav P. Vaghela

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Work-related musculoskeletal symptoms (WMS) are a major health issue in many occupations all over the world. Past research on hospital workers have mainly been focused on nurses [8] and very few studies have examined musculoskeletal symptoms among doctors in various specialties. The work of surgeons can involve high levels of mental concentration and very precise movements that can be categorized as mild-to-moderate physical demands. Design: Forty-three surgeons were enrolled in this study. To investigate musculoskeletal disorder among the surgeons we had used Standardised Nordic Questionnaire, Quick Exposure Check (QEC) and Workstyle Short Form. Result: In the current study, total 43 surgeons participants out of 30 males and 13 females. Their mean age was 42.07 ± 12.35, and the mean working years of the group were 15.14years ±9.017. On the average, they worked a total of about 8.58 h (±1.967) per day. The prevalence of work related musculoskeletal symptoms among the surgeons indicating 83.70% surgeons had atleast one joint affected while 16.30% had no symptoms at all. Conclusion: The present survey study has shown high prevalence rates of neck, back and shoulder musculoskeletal symptoms in surgeons.

Keywords: repetitive stress injury, pain, occupational hazards, disability, abneetism, physical health, quality of life

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Authors: Amit Syal, Madeline Grade, Alister Martin

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Background: Cross-sectional and longitudinal studies demonstrate an association between health and voting. Furthermore, voting enables populations to support policies that impact their health via social determinants like income, education, housing, and healthcare access. Unfortunately, many barriers exist which disproportionately affect the civic participation of certain minority groups. Health professionals have an important role to play in addressing the civic health of all patients and empowering underrepresented communities. Description: Vot-ER is a non-partisan, nonprofit organization that aims to reduce barriers to civic participation by helping patients register to vote while in healthcare settings. The initial approach involved iPad-based kiosks in the emergency department waiting rooms, allowing patients to register themselves while waiting. After the COVID-19 pandemic began, Vot-ER expanded its touchless digital approaches. Vot-ER provides healthcare workers across the country with “Healthy Democracy Kits” consisting of badge backers, posters, discharge paperwork, and other resources. These contain QR and text codes that direct users to an online platform for registering to vote or requesting a mail-in ballot, available in English or Spanish. Outcomes: From May to November 2020, Vot-ER helped prepare 46,320 people to vote. 13,192 individual healthcare providers across all 50 states signed up for and received Healthy Democracy Kits. 80 medical schools participated in the Healthy Democracy Campaign competition. Over 500 institutions ordered site-based materials. Conclusions: A healthy democracy is one in which all individuals in a community have equal and fair opportunities for their voices to be heard. Healthcare settings, such as hospitals, are appropriate and effective venues for increasing both voter registration and education.

Keywords: civic health, enfranchisement, physician, voting

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Authors: Rosyellen Rabelo Szvarça, Pedro Fialho, Auristela Duarte de Lima Moser

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Background: New ways of working, such as teleworking or hybrid working, have changed and have impacted both employees and organizations. To understand the individuals' perceptions among different working models, this study aimed to investigate levels of psychological safety among employees working in person, hybrid, and remote environments and the correlation of demographic or professional characteristics. Methods: A cross-sectional survey was distributed electronically. A self-administered questionnaire was composed of sociodemographic data, academic status, professional contexts, working models, and the seven-item instrument of psychological safety. The psychological safety instrument was computed to determine its reliability, showing a Cronbach’s 0.75, considering a good scale when compared to the original, analyzed with 51 teams from a North American company, with a Cronbach's alpha coefficient of 0.82. Results: The survey was completed by 328 individuals, 60% of whom were in-person, 29.3% hybrid, and 10.7% remote. The Chi-Square test with the Bonferroni post-test for qualitative variables associated with the working models indicates a significant association (p 0.001) for academic qualifications. In-person models present 29.4% of individuals with secondary education and 38.1% undergraduate; hybrid present 51% postgraduate and 35.4% undergraduate. This was similar to remote workers, with 48.6% postgraduate and 34.3% undergraduate. There were no significant differences in gender composition between work models (p = 0.738), with most respondents being female in all three work groups. Remote workers predominated in areas such as commerce, marketing, and services; education and the public sector were common in the in-person group, while technology and the financial sector were predominant among hybrid workers (p < 0.001). As for leadership roles, there was no significant association with working models (p = 0.126). The decision on the working model was predominantly made by the organization for in-person and hybrid workers (p < 0.001). Preference for the working model was in line with the workers' scenario at that time (p < 0.001). Kruskal-Wallis test with Bonferroni's post hoc test compared the psychological safety scores between working groups, reveling statistically higher scores in hybrid group x̃ = 5.64 compared to in-person group x̃ = 5, with remote workers showing scores similar to other groups x̃ = 5.43 (p = 0.004). Age demonstrated no significant difference between the working groups (p = 0.052). On the other hand, organization tenure and job tenure were higher in in-person groups compared to the hybrid and remote groups (p < 0.001). The hybrid model illustrates a balance between in-person and remote models. The results highlight that higher levels of psychological safety can be correlated with the flexibility of hybrid work, as well as physical interaction, spontaneity, and informal relationships, which are considered determinants of high levels of psychological safety. Conclusions: Psychological safety at the group level using the seven-item scale is widely employed in comparison to other commonly employed measures. Despite psychological safety having been around for decades, primarily studied in in-person work contexts, the current findings contribute to expanding research with hybrid or remote settings. Ultimately, this investigation has demonstrated the significance of work models in assessing psychological safety levels.

Keywords: hybrid work, new ways of working, psychological safety, workplace, working models

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Authors: Esther Paul, Ibrahim A. M. Alzaydani, Al Hakami, Caryl Beynon

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Research Objectives and Goal: The main aim of the current study was to explore the perspectives of healthcare workers on Healthcare-associated infections (HAI) and infection control measures in a tertiary care Hospital in Abha, Saudi Arabia. As per our knowledge, this is perhaps the first qualitative study on HAI to be done in Saudi Arabia. The goal of the study was to understand the perspectives of the healthcare workers on the current protocol and guidelines for HAI and infections control measures in the hospital, the effectiveness of the current protocol for HAI and infection control measures and ways of reducing the incidence of HAI and improve infection control measures. Methods used: A qualitative research design was used to collect the data from 25 healthcare workers consisting of doctors and nurses, recruited by Snowball strategy via semi-structured interviews which were audio-recorded and transcribed verbatim immediately. An interview guide consisting of open-ended questions about the existing HAI and infection control practices in the healthcare facility, the awareness of the healthcare workers about HAI and the need for safe infection control measures were used to collect the data. The transcribed data were analyzed using the thematic analysis method. Results: Using thematic analysis four themes were identified.1.Knowledge of HAI and infection control 2. Infection control measures in practice 3. The gap in infection control measures and HAI 4. Required Implementations. The first theme covered the participants' knowledge on HAI, its definition, the types of HAI and the infection control measures.Most of the participants were aware of HAI and had some idea of the definition of HAI, its significance and the dangers posed by HAI, but few residents had no idea of the types of HAI. The second theme was focussed on the infection control measures in practice. Most of the participants were aware of the importance of infection control measures like hand hygiene, catheter care, and waste disposal. The nurses were responsible for most of the disinfection and sterilization measures and practiced it effectively. However, some doctors and residents had no inkling about these measures. The third theme emphasized that although most of the participants were aware of HAI and infection control measures and were in practice. There were some lacunae regarding their knowledge of the different types of HAI, Personal Protective Equipment practices, communication among the healthcare personnel and the hospital administrations and the means of waste disposal. The fourth and the final theme identified that most of the participants felt the need for implementations of changes regarding existing protocols, workshops/seminars, methods of waste disposal and sterilization and disinfection practices. Conclusion: The current qualitative study concluded that there is a need for better educational programs and hands-on training for all the healthcare personnel including the paramedical staff as well. The residents should have adequate knowledge of infection control practices to guide the nurses and should share the responsibility with the nurses in the practice of effective infection control measures

Keywords: healthcare-associated infections, infection control measures, perspectives, qualitative

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Authors: Bouba Oumarou Aboubakar, HongXia Li, Sardar Annes Farooq

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The Belt and Road Initiative’s success strongly depends on the safety of all the million workers on construction projects sites. As the new BRI is directed toward Africa and meets a completely different culture from the Chinese project managers, maintaining low risk for workers risks shall be closely related to cultural sharing and mutual understanding. This is why this work introduces a cultural-wise safety management framework for Chinese Construction projects in Africa. The theoretical contribution of this paper is an improved risk assessment framework that integrates language, culture and difficulty of controlling risk factors into one approach. Practically, this study provides not only a useful tool for project safety management practitioners but the full understanding of all risks that may arise in the BRI projects in Africa.

Keywords: cultural-wise, safety culture, risk assessment, Chinese construction, BRI projects, Africa

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Authors: Fatemeh Abdollahi, Munn-Sann Lye, Jamshid Yazdani Charati, Mehran Zarghami

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Background: In March 2020, the World Health Organization (WHO) declared the outbreak of a new coronavirus disease, COVID-19, as a public health concern and pandemic. This situation is generating psychological consequences such as stress, anxiety, depression, and intimate partner violence (IPV) throughout the population. This is a brief note on the magnitude of this threat and different ways for abused women to minimize the effects of it in their daily life. Methods: A literature review was conducted using the MEDLINE, PSYCHINFO, and SCIENCE DIRECT databases. The keywords used included intimate partner violence, abuse, victims, pandemic, quarantine, coronavirus, and COVID-19. A Google search was also conducted using these words to identify reports published in non-indexed health care and social science journals. The literature search was restricted to English language studies. Results: The prevalence of IPV and its consequences are rising during such a pandemic. Having sufficient support from healthcare workers and acquaintances is critical for women in such circumstances. Conclusion: Community members, healthcare providers, governments, and policymakers should be informed of the increased risk of IPV during such a pandemic. They should provide a supporting structure for abused women. Social networking is also a good approach that could help abusive women during this situation.

Keywords: covid-19, intimate partner violence, pandemic, women

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Authors: Baluku Nathan

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Infection prevention and control (IPC) is a practical, evidence-based approach that prevents patients and emergency health workers from being harmed by avoidable infections as a result of antimicrobial resistance; all hospital infection control programs put together various practices which, when used appropriately, restrict the spread of infection. A breach in these control practices facilitates the transmission of infections from patients to health workers, other patients and attendants. It is, therefore, important for all EMTs and patients to adhere to them strictly. It is also imperative for administrators to ensure the implementation of the infection control program for their facilities. Purpose: The purpose of this study was to investigate the influencing factors of prevention practices against Infection exposure among emergency medical technicians (EMTs) in the emergency department at Mbarara hospital. Methodology: This was a descriptive cross-sectional study that employed a self-reported questionnaire that was filled out by 32 EMTs in the emergency department from 12th February to 3rd march 2022. The questionnaire consisted of items concerning the defensive environment and other Factors influencing Infection prevention and control practices in the accident and emergency department of Mbarara hospital. Results: From the findings, majority16(50%) always used protective gear when doing clinical work,14 (43.8%) didn’t use protective gear, citing they were only assisting those performing resuscitations, gumboots were the least used protective gear with only3(9.4%) usage. Regarding disposal techniques of specific products like blood and sharps, results showed 10 (31.3%) said blood is disposed of in red buckets, 5(15.6%) in yellow buckets and only5(15.6%) in black buckets and 12(37.5%) didn’t respond. However, 28(87.5%) said sharps were disposed of in a sharps container. The majority, 17(53.1%), were not aware of the infection control guidelines even though they were pinned on walls of the emergency rooms,15(46.9%) said they had never had quality assurance monitoring events,14(43.8%) said monitoring was continuous while15(46.9 %) said it was discrete. Conclusions: The infection control practices at the emergency department were inadequate in view of less than 100% of the EMTs observing the five principles of infection prevention, such as the use of personal protective equipment and proper waste disposal in appropriate color-coded bins. Dysfunctional infection prevention and control committees accompanied by inadequate supervision to ensure infection control remained a big challenge.

Keywords: infection prevention, influencing factors, emergency medical technician (EMT), emergency unit

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Authors: Baluku Nathan

Abstract:

Infection prevention and control (IPC) is a practical, evidence-based approach that prevents patients and emergency health workers from being harmed by avoidable infections as a result of antimicrobial resistance; all hospital infection control programs put together various practices which, when used appropriately, restrict the spread of infection. A breach in these control practices facilitates the transmission of infections from patients to health workers, other patients, and attendants. It is, therefore important for all emergency medical technicians (EMTs) and patients to strictly adhere to them. It is also imperative for administrators to ensure the implementation of the infection control programme for their facilities. Purpose: The purpose of this study was to investigate the influencing factors of prevention practices against infection exposure among emergency medical technicians (EMTs) in the emergency department at Mbarara hospital. Methodology: This was a descriptive cross-sectional study that employed a self-reported questionnaire that was filled out by 32 EMTs in the emergency department from 12th February to 3rd march 2022. The questionnaire consisted of items concerning the defensive environment and other factors influencing infection prevention and control practices in the accident and emergency department of Mbarara hospital. Results: From the findings, the majority 16 (50%) always used protective gear when doing clinical work, 14 (43.8%) didn’t use protective gear, citing they were only assisting those performing resuscitations, gumboots were the least used protective gear with only3(9.4%) usage. About disposal techniques of specific products like blood and sharps, results showed 10 (31.3%) said blood is disposed of in red buckets, 5 (15.6%) in yellow buckets, and only 5(15.6%) in black buckets, and 12(37.5%) didn’t respond, however, 28(87.5%) said sharps were disposed of in a sharps container. The majority, 17 (53.1%), were not aware of the infection control guidelines even though they were pinned on walls of the emergency rooms, 15(46.9%) said they have never had quality assurance monitoring events, 14(43.8%) said monitoring was continuous while 15(46.9 %) said it was discrete. Conclusions: The infection control practices at the emergency department were inadequate in view of less than 100% of the EMTs observing the five principles of infection prevention, such as the use of personal protective equipment and proper waste disposal in appropriate color-coded bins. Dysfunctional infection prevention and control committees accompanied by inadequate supervision to ensure infection control remained a big challenge.

Keywords: emergency medical technician, infection prevention, influencing factors, infection control

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Authors: Anne Jane M. Hallasgo

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This study assessed the level of job satisfaction and organizational commitment among job order personnel at the Overseas Workers Welfare Administration (OWWA) Regional Welfare Office Caraga. The primary objective of the study was to determine a correlation between the employees’ level of organizational commitment, job satisfaction, and their work performance. A carefully selected sample of twenty-five job orders from the OWWA Regional Welfare Office Caraga participated in the study. These individuals were chosen to represent the organization’s job order workforce. For accuracy and dependability, various types of statistical methods and instruments were employed, including advanced statistical tests like the independent sample T-test, one-way analysis of variance (ANOVA), and Spearman's rank correlation coefficient, as well as descriptive statistics like mean, frequency, and percentage. The study found an acceptable level of job satisfaction regarding work performance. It revealed a significant relationship between affective commitment and job satisfaction concerning leadership and coworkers. A correlation was observed between normative commitment and work performance. The findings suggest that organizations emphasizing positive leadership, fostering supportive coworker relationships, aligning with employee values, and promoting a culture of commitment are likely to enhance both affective and normative commitment, thereby improving overall employee satisfaction. The study recommends designing and implementing a holistic employee well-being program that addresses physical, mental, and emotional health contributing to increased job satisfaction and organizational commitment, creating a healthier and engaged workforce. This research contributes to the understanding of the dynamics of organizational commitment and job satisfaction among job order employees in the public sector.

Keywords: affective commitment, continuous commitment, normative commitment, job satisfaction

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Authors: Amar Ghelani

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People with auditory verbal hallucinations (AVH) who seek support from mental health services commonly report feeling unheard and invalidated in their interactions with social workers and psychiatric professionals. Current mental health training and clinical approaches have proven to be inadequate in addressing the complex nature of voice hearing. Childhood trauma is a key factor in the development of AVH and can render people more vulnerable to hearing both supportive and/or disturbing voices. Lived experiences of racism, poverty, and immigration are also associated with development of what is broadly classified as psychosis. Despite evidence affirming the influence of environmental factors on voice hearing, the Western biomedical system typically conceptualizes this experience as a symptom of genetically-based mental illnesses which requires diagnosis and treatment. Overemphasis on psychiatric medications, referrals, and directive approaches to people’s problems has shifted clinical interventions away from assessing and addressing problems directly related to AVH. The Maastricht approach offers voice hearers and mental health workers an alternative and respectful starting point for understanding and coping with voices. The approach was developed by voice hearers in partnership with mental health professionals and entails an innovative method to assess and create meaning from voice hearing and related life stressors. The objectives of the approach are to help people who hear voices: (1) understand the problems and/or people the voices may represent in their history, and (2) cope with distress and find solutions to related problems. The Maastricht approach has also been found to help voice hearers integrate emotional conflicts, reduce avoidance or fear associated with AVH, improve therapeutic relationships, and increase a sense of control over internal experiences. The proposed oral presentation will be guided by a recovery-oriented theoretical framework which suggests healing from psychological wounds occurs through social connections and community support systems. The presentation will start with a brainstorming exercise to identify participants pre-existing knowledge of the subject matter. This will lead into a literature review on the relations between trauma, intersectionality, and AVH. An overview of the Maastricht approach and review of research related to its therapeutic risks and benefits will follow. Participants will learn trauma-informed coping skills and questions which can help voice hearers make meaning from their experiences. The presentation will conclude with a review of resources and learning opportunities where participants can expand their knowledge of the Hearing Voices Movement and Maastricht approach.

Keywords: Maastricht interview, recovery, therapeutic assessment, voice hearing

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Authors: Atin Adhikari, Aniruddha Mitra, Abbas Rashidi, Imaobong Ekpo, Jefferson Doehling, Alexis Pawlak, Shane Lewis, Jacob Schwartz

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Building constructions in the US involve numerous wooden structures. Woods are routinely used in walls, framing floors, framing stairs, and making of landings in building constructions. Cross-laminated timbers are currently being used as construction materials for tall buildings. Numerous workers are involved in these timber based constructions, and wood dust is one of the most common occupational exposures for them. Wood dust is a complex substance composed of cellulose, polyoses and other substances. According to US OSHA, exposure to wood dust is associated with a variety of adverse health effects among workers, including dermatitis, allergic respiratory effects, mucosal and nonallergic respiratory effects, and cancers. The amount and size of particles released as wood dust differ according to the operations performed on woods. For example, shattering of wood during sanding operations produces finer particles than does chipping in sawing and milling industries. To our knowledge, how shattering, cutting and sanding of woods and wood slabs during new building construction release fine particles and nanoparticles are largely unknown. General belief is that the dust generated during timber cutting and sanding tasks are mostly large particles. Consequently, little attention has been given to the generated submicron ultrafine and nanoparticles and their exposure levels. These data are, however, critically important because recent laboratory studies have demonstrated cytotoxicity of nanoparticles on lung epithelial cells. The above-described knowledge gaps were addressed in this study by a novel newly developed nanoparticle monitor and conventional particle counters. This study was conducted in a large new building construction site in southern Georgia primarily during the framing of wooden side walls, inner partition walls, and landings. Exposure levels of nanoparticles (n = 10) were measured by a newly developed nanoparticle counter (TSI NanoScan SMPS Model 3910) at four different distances (5, 10, 15, and 30 m) from the work location. Other airborne particles (number of particles/m3) including PM2.5 and PM10 were monitored using a 6-channel (0.3, 0.5, 1.0, 2.5, 5.0 and 10 µm) particle counter at 15 m, 30 m, and 75 m distances at both upwind and downwind directions. Mass concentration of PM2.5 and PM10 (µg/m³) were measured by using a DustTrak Aerosol Monitor. Temperature and relative humidity levels were recorded. Wind velocity was measured by a hot wire anemometer. Concentration ranges of nanoparticles of 13 particle sizes were: 11.5 nm: 221 – 816/cm³; 15.4 nm: 696 – 1735/cm³; 20.5 nm: 879 – 1957/cm³; 27.4 nm: 1164 – 2903/cm³; 36.5 nm: 1138 – 2640/cm³; 48.7 nm: 938 – 1650/cm³; 64.9 nm: 759 – 1284/cm³; 86.6 nm: 705 – 1019/cm³; 115.5 nm: 494 – 1031/cm³; 154 nm: 417 – 806/cm³; 205.4 nm: 240 – 471/cm³; 273.8 nm: 45 – 92/cm³; and 365.2 nm: Keywords: wood dust, industrial hygiene, aerosol, occupational exposure

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Authors: Maria Del Mar Maira Vidal, Alvaro Briales

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In this paper, we will conduct an analysis of the results of the I+D+i research project “New types of socio-existential vulnerability, support and care in Spain” (VULSOCU) (2016-20). This project had the objective to analyze the new types of vulnerability that are the result of the combination of several factors as the economic crisis, the unemployment, the transformations of the Welfare State, the individualization, etc. We have, therefore, analyzed the way that Spanish long-term unemployed over 45 years experience vulnerability and its consequences on their lives. We have focused on long-term unemployed over 45 that had previously developed stable career paths and have been looking for a job for two years or more. In order to carry out this analysis, we will try to break the dichotomy between the social and the individual, between the socio-historical and the subjectivity, to overcome some of the limits of the research on unemployment. The fieldwork consisted of more than ten focus groups and fifty in-depth interviews. The work and life ethics completely changed at the turn of the nineteenth and twentieth centuries. In the nineteenth century, companies had trouble maintaining their staff, but in the 21st century, unemployed workers feel that they are useless people. Workers value themselves if they have a job. This unveils that labor is a comprehensive social relationship in capitalist societies. In general, unemployed workers are not able to analyze their unemployment as a social problem. They analyze their unemployment as an individual problem. They blame themselves for their unemployment; instead of taking into account that there are millions of unemployed, they talk about themselves as if they were on their own. And the problems caused by unemployment are explained as psychological problems and are medicalized. Anyway, it is important to highlight that this is the result of an ideology and a social relationship that is part of our historical time.

Keywords: life ethics, work ethics, unemployment, unemployed over 45 years old

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Authors: Anna Guitart Atienza, Ana Fernández del Río, Madhav Nekkar, Jelena Ljubicic, África Periáñez, Eura Shin, Lauren Bellhouse

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The use of digital devices in healthcare or mobile health (mHealth) has increased in recent years due to the advances in digital technology, making it possible to nudge healthy behaviors through individual interventions. In addition, mHealth is becoming essential in poor-resource settings due to the widespread use of smartphones in areas where access to professional healthcare is limited. In this work, we evaluate mHealth interventions in low-income countries with a focus on causal inference. Counterfactuals estimation and other causal computations are key to determining intervention success and assisting in empirical decision-making. Our main purpose is to personalize treatment recommendations and triage patients at the individual level in order to maximize the entire intervention's impact on the desired outcome. For this study, collected data includes mHealth individual logs from front-line healthcare workers, electronic health records (EHR), and external variables data such as environmental, demographic, and geolocation information.

Keywords: causal inference, mHealth, intervention, personalization

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Authors: Juan Carlos Rubio Romero, Francico Salguero Caparros, Virginia Herrera-Pérez

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No one is in the slightest doubt about the high levels of risk involved in work in the construction industry. They are even higher in structural construction work. The Critical Decision Method (CDM) is a semi-structured interview technique that uses cognitive tests to identify the different disturbances that workers have to deal with in their work activity. At present, the vision of safety focused on daily performance and things that go well for safety and health management is facing the new paradigm known as Resilience Engineering. The aim of this study has been to describe the variability in formwork labour on concrete structures in the construction industry and, from there, to find out the resilient attitude of workers to unexpected events that they have experienced during their working lives. For this purpose, a series of semi-structured interviews were carried out with construction employees with extensive experience in formwork labour in Spain by applying the Critical Decision Method. This work has been the first application of the Critical Decision Method in the field of construction and, more specifically, in the execution of structures. The results obtained show that situations categorised as unthought-of are identified to a greater extent than potentially unexpected situations. The identification during these interviews of both expected and unexpected events provides insight into the critical decisions made and actions taken to improve resilience in daily practice in this construction work. From this study, it is clear that it is essential to gain more knowledge about the nature of the human cognitive process in work situations within complex socio-technical systems such as construction sites. This could lead to a more effective design of workplaces in the search for improved human performance.

Keywords: resilience engineering, construction industry, unthought-of situations, critical decision method

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Authors: Anwar Hassen Tsega

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International labor migration is an integral part of the modern globalized world. However, the phenomenon has its roots in some earlier periods in human history. This paper discusses the relatively new phenomenon of female migration in Africa. In the past, African women migrants were only spouses or dependent family members. But as modernity swept most African societies, with rising unemployment rates, there is evidence everywhere in Africa that women labor migration is a growing phenomenon that deserves to be understood in the context of human security research. This work explores these issues further, focusing on the experience of Ethiopian women labor migrants to Sudan. The migration of Ethiopian people to Sudan is historical; nevertheless, labor migration mainly started since the discovery and subsequent exploration of oil in the Sudan. While the paper is concerned with the human security aspect of the migrant workers, we need to be certain that the migration process will provide with a decent wage, good working conditions, the necessary social security coverage, and labor protection as a whole. However, migration to Sudan is not always safe and female migrants become subject to violence at the hands of brokers, employers and migration officials. For this matter, the paper argued that identifying the vulnerable stages and major problem facing female migrant workers at various stages of migration is a prerequisite to combat the problem and secure the lives of the migrant workers. The major problems female migrants face include extra degrees of gender-based violence, underpayment, various forms of abuse like verbal, physical and sexual and other forms of torture which include beating and slaps. This peculiar situation could be attributed to the fact that most of these women are irregular migrants and fall under the category of unskilled and/or illiterate migrants.

Keywords: Ethiopia, human security, labor migration, Sudan

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Authors: Rusmawati Said, N. Kar Yee, Asmaddy Haris

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This study employs a panel data set of ASEAN member states, 17 European Union (EU) countries, 7 American countries and 11 other Asia Pacific countries (China Mainland and Hong Kong SAR are treated as two separated countries) to investigate the role of labour standards in explaining the pattern of bilateral migration flows in ASEAN. Using pooled Ordinary Least Square (OLS) this study found mixed results. The result varies on how indicators were used to measure the level of labour standards in the empirical analysis. In one side, better labour standards (represented by number of strikes and weekly average working hours) promote bilateral migration among the selected countries. On the other side, increase in cases of occupational injuries lead to an increase in bilateral migration, reflecting that worsen in working conditions do not influence the workers’ decision from moving. The finding from this study become important to policy maker as the issues of massive low skilled workers have a significant impact to the role of labour standard in shaping the migration flows.

Keywords: labour standard, migration, ASEAN, economics and financial engineering

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Authors: S. Bellagamba, S. Malinconico, P. De Simone, F. Paglietti

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Until the 1990s, Italy was among the world’s leading producers of raw asbestos fibres and Asbestos Containing Materials (ACM) and one of the most contaminated Countries in Europe. To reduce asbestos-related health effects, Italy has adopted many laws and regulations regarding exposure thresholds, limits, and remediation tools. The Italian Environmental Ministry (MASE) has identified 42 Italian Superfund sites, 11 of which are mainly contaminated by Asbestos. The highest levels of exposure occur during remediation activities in the 42 superfund-sites and during the management of asbestos containing waste in landfills, which requires specific procedures. INAIL-DIT play a role as MASE scientific consultant on issues concerning pollution, remediation, and Asbestos Containing Waste (ACW) management. The aim is to identify the best Emergency Safety Measures, to suggest specific best pratics for remediation through occupational on site monitorings and laboratory analysis. Moreover, the aim of INAIL research is testing the available technologies for working activities and analytical methodologies. This paper describes the remediation of Bagnoli industrial facility (Naples), an Eternit factory which produced asbestos cement products. The remediation has been analyzed, considering a first phase focused on the demolition of structures and plants and a second phase regarding the characterization, screening, removal, and disposal of polluted soils. The project planned the complete removal of all the asbestos dispersed in the soil and subsoil and the recovery of the clean fraction. This work highlights the remediation techniques used and the prevention measures provide for workers and daily life areas protection. This study, considering the high number of asbestos cement factories in the world, can to serve as an important reference for similar situation at European or international scale.

Keywords: safety, asbestos, workers, contaminated sites, hazardous waste

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Authors: M. Kasusse, M. Rosette, E. Burke, C. Mwangi, R. Batamwita, N. Tumwesigye, S. Aisu

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A cross-sectional survey to ascertain the capacity of laboratory persons in using ICTs was conducted in 15 Ugandan districts (July-August 2013). A self-administered questionnaire served as data collection tool, interview guide and observation checklist. 69 questionnaires were filled, 12 interviews conducted, 45 HC observed. SPSS statistics 17.0 and SAS 9.2 software were used for entry and analyses. 69.35% of participants find it difficult to access a computer at work. Of the 30.65% who find it easy to access a computer at work, a significant 21.05% spend 0 hours on a computer daily. 60% of the participants cannot access internet at work. Of the 40% who have internet at work, a significant 20% lack email address but 20% weekly read emails weekly and 48% daily. It is viable/feasible to pilot informatics projects as strategies to build bridges develop skills for e-health landscape in laboratory services with a bigger financial muscle.

Keywords: ICT behavior, clinical laboratory persons, Sub-Saharan Africa, Uganda

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Authors: Ágnes Győri, Éva Perpék, Zsófia Bauer, Zsuzsanna Elek

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The aim of the research (funded by Hungarian national grant, NFKI- FK 138315) is to examine the professional mobility, mental health and work environment of social workers with a complex approach. Previous international and Hungarian research has pointed out that those working in the helping professions are strongly exposed to the risk of emotional-mental-physical exhaustion due to stress. Mental and physical strain, as well as lack of coping (can) cause health problems, but its role in career change and high labor turnover has also been proven. Even though satisfaction with working conditions of those employed in the human service sector in the context of the stress burden has been researched extensively, there is a lack of large-sample international and Hungarian domestic studies exploring the effects of profession-specific conditions. Nor has it been examined how the specific features of the social profession and mental health affect the career mobility of the professionals concerned. In our research, these factors and their correlations are analyzed by means of mixed methodology, utilizing the benefits of netnographic big data analysis and a sector-specific quantitative survey. The netnographic analysis of open web content generated inside and outside the social profession offers a holistic overview of the influencing factors related to mental health and the work environment of social workers. On the one hand, the topics and topoi emerging in the external discourse concerning the sector are examined, and on the other hand, focus on mentions and streams of comments regarding the profession, burnout, stress, coping, as well as labor turnover and career changes among social professionals. The analysis focuses on new trends and changes in discourse that have emerged during and after the pandemic. In addition to the online conversation analysis, a survey of social professionals with a specific focus has been conducted. The questionnaire is based on input from the first two research phases. The applied approach underlines that the mobility paths of social professionals can only be understood if, apart from the general working conditions, the specific features of social work and the effects of certain aspects of mental health (emotional-mental-physical strain, resilience) are taken into account as well. In this paper, the preliminary results from this innovative methodological mix are presented, with the aim of highlighting new opportunities and dimensions in the research on social work. A gap in existing research is aimed to be filled both on a methodological and empirical level, and the Hungarian domestic findings can create a feasible and relevant framework for a further international investigation and cross-cultural comparative analysis. Said results can contribute to the foundation of organizational and policy-level interventions, targeted programs whereby the risk of burnout and the rate of career abandonment can be reduced. Exploring different aspects of resilience and mapping personality strengths can be a starting point for stress-management, motivation-building, and personality-development training for social professionals.

Keywords: burnout, mixed methods, netnography, professional mobility, social work

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Authors: Jocelyne Uwibambe, Ange Thaina Ndizeye, Dinah Ishimwe, Emmanuel Mugabo Byakagaba

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Background: In low- and middle-income countries (LMICs), the use of modern contraceptive methods among women, including adolescents, is still low despite the desire to avoid pregnancy. In addition, countries have set a minimum age for marriage, which is 21 years for most countries, including Rwanda. The Rwandan culture, to a certain extent, and religion, to a greater extent, however, limit the freedom of young women to use contraceptive services because it is wrongly perceived as an encouragement for premarital sexual intercourse. In the end, what doesn’t change is that denying access to contraceptives to either male or female adolescents does not translate into preventing them from sexual activities, hence leading to an ever-increasing number of unwanted pregnancies, possible STIs, HIV, Human Papilloma Virus, and subsequent unsafe abortion followed by avoidable expensive complications. The purpose of this study is to evaluate the perception of healthcare providers regarding contraceptive use among adolescents. Methodology: This was a qualitative study. Interviews were done with different healthcare providers, including doctors, nurses, midwives, and pharmacists, through focused group discussions and in-depth interviews, then the audio was transcribed, translated and thematic coding was done. Results: This study explored the perceptions of healthcare workers regarding the provision of modern contraception to adolescents in Rwanda. The findings revealed that while healthcare providers had a good understanding of family planning and contraception, they were hesitant to provide contraception to adolescents. Sociocultural beliefs played a significant role in shaping their attitudes, as many healthcare workers believed that providing contraception to adolescents would encourage promiscuous behavior and go against cultural norms. Religious beliefs also influenced their reluctance, with some healthcare providers considering premarital sex and contraception as sinful. Lack of knowledge among parents and adolescents themselves was identified as a contributing factor to unwanted pregnancies, as inaccurate information from peers and social media influenced risky sexual behavior. Conditional policies, such as the requirement for parental consent, further hindered adolescents' access to contraception. The study suggested several solutions, including comprehensive sexual and reproductive health education, involving multiple stakeholders, ensuring easy access to contraception, and involving adolescents in policymaking. Overall, this research highlights the need for addressing sociocultural beliefs, improving healthcare providers' knowledge, and revisiting policies to ensure adolescents' reproductive health rights are met in Rwanda. Conclusion: The study highlights the importance of enhancing healthcare provider training, expanding access to modern contraception, implementing community-based interventions, and strengthening policy and programmatic support for adolescent contraception. Addressing these challenges is crucial for improving the provision of family planning services to adolescents in Rwanda and achieving the Sustainable Development Goals related to sexual and reproductive health. Collaborative efforts involving various stakeholders and organizations can contribute to overcoming these barriers and promoting the well-being of adolescents in Rwanda.

Keywords: adolescent, health care providers, contraception, reproductive health

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Authors: Emanuela Zilli, Suana Tikvina, Davide Bonaldo, Monica Varotto, Scilla Rizzardi, Barbara Ruzzante, Raffaele Napolitano, Stefano Bevilacqua, Antonella Ruffatto

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A healthy workplace increases productivity, creativity and decreases absenteeism and turnover. It also contributes to creating a more secure work environment with fewer risks of violence. In the past 3 years, the healthcare system has suffered the psychological, economic and social consequences of the COVID-19 pandemic. On the other hand, the healthcare staff reductions determine high levels of work-related stress that are often unsustainable. The Hospital of Cittadella (in the province of Padua) has 400 beds and serves a territory of 300,000 inhabitants. The hospital itself counts 1.250 healthcare employees (healthcare professionals). This year, the Medical Board of Directors has requested additional staff; however, the economic situation of Italy can not sustain additional hires. At the same time, we have initiated projects that aim to increase well-being, decrease stress and encourage activities that promote self-care. One of the projects that the hospital has organized is the psychomotor practice. It is held by therapists and trainers who operate according to the traditional method. According to the literature, the psychomotor practice is specifically intended for the staff operating in the Intensive Care Unit, Emergency Department and Pneumology Ward. The project consisted of one session of 45 minutes a week for 3 months. This method brings focus to controlled breathing, posture, muscle work and movement that help manage stress and fatigue, creating a more mindful and sustainable lifestyle. In addition, a Qigong course was held every two weeks for 5 months. It is an ancient Chinese practice designed to optimize the energy within the body, reducing stress levels and increasing general well-being. Finally, Tibetan singing crystal bowls sessions, held by a music therapist, consisted of monthly guided meditation sessions using the sounds of the crystal bowls. Sound therapy uses the vibrations created from the crystal bowls to balance the vibrations within the body to promote relaxation. In conclusion, well-being and organizational performance are closely related to each other. It is crucial for any organization to encourage and maintain better physical and mental health of the healthcare staff as it directly affects productivity and, consequently, user satisfaction of the services provided.

Keywords: health promotion, healthcare workers management, Weel being and organizational performance, Psychomotor practice

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Authors: Iman Shabanzadeh

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Over the last three decades, the main demands of the Iranian workforce have been focused on three areas: "The right to a decent wage", "The right to organize" and "The right to job security". In order to investigate and analyze this situation, the present study focuses on the component of job security. The purpose of the study is to figure out what mechanisms in Iran's Labor Law have led to the destabilization and undermining of workers' job security. The research method is descriptive-analytical. To collect information, library and document sources in the field of laws related to labor rights in Iran and, semi-structured interviews with experts have been used. In the data analysis stage, the qualitative content analysis method was also used. The trend analysis of the statistics related to the labor force situation in Iran in the last three decades shows that the employment structure has been facing an increase in the active population, but in the last decade, a large part of this population has been mainly active in the service sector, and contract-free enterprises, so a smaller share of this employment has insurance coverage and a larger share has underemployment. In this regard, the results of this study show that four contexts have been proposed as the main legal and executive mechanisms of labor instability in Iran, which are: 1) temporaryization of the labor force by providing different interpretations of labor law, 2) adjustment labor in the public sector and the emergence of manpower contracting companies, 3) the cessation of labor law protection of workers in small workshops and 4) the existence of numerous restrictions on the effective organization of workers. The theoretical conclusion of this article is that the main root of the challenges of the labor society and the destabilized workforce in Iran is the existence of structural inequalities in the field of labor security, whose traces can be seen in the legal provisions and executive regulations of this field.

Keywords: inequality, precariat, temporaryization, labor force, labor law

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Authors: Salima Bijapuri, Shweta Bhatbolan, Sejalben Patel

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Ergonomics concerns the fitting of the environment and the equipment to the worker. Ergonomic principles can be employed in different dimensions of the industrial sector. Participation of all the stakeholders is the key to the formulation of a multifaceted and comprehensive approach to lessen the burden of occupational hazards. Taking responsibility for one’s own work activities by acquiring sufficient knowledge and potential to influence the practices and outcomes is the basis of participatory ergonomics and even hastens the process to identify workplace hazards. The study was aimed to check how participatory ergonomics can be effective in the management of work-related musculoskeletal disorders. Method: A mega kitchen was identified in a twin city of Karnataka, India. Consent was taken, and the screening of workers was done using observation methods. Kitchen work was structured to include different tasks, which included preparation, cooking, distributing, and serving food, packing food to be delivered to schools, dishwashing, cleaning and maintenance of kitchen and equipment, and receiving and storing raw material. Total 100 workers attended the education session on participatory ergonomics and its role in implementing the correct ergonomic practices, thus preventing WRMSDs. Demographic details and baseline data on related musculoskeletal pain and discomfort were collected using the Nordic pain questionnaire and VAS score pre- and post-study. Monthly visits were made, and the education sessions were reiterated on each visit, thus reminding, correcting, and problem-solving of each worker. After 9 months with a total of 4 such education session, the post education data was collected. The software SPSS 20 was used to analyse the collected data. Results: The majority of them (78%), depending on the availability and feasibility, participated in the intervention workshops were arranged four times. The average age of the participants was 39 years. The percentage of female participants was 79.49%, and 20.51% of participants comprised of males. The Nordic Musculoskeletal Questionnaire (NMQ) showed that knee pain was the most commonly reported complaint (62%) from the last 12 months with a mean VAS of 6.27, followed by low back pain. Post intervention, the mean VAS Score was reduced significantly to 2.38. The comparison of pre-post scores was made using Wilcoxon matched pairs test. Upon enquiring, it was found that, the participants learned the importance of applying ergonomics at their workplace which inturn was beneficial for them to handle any problems arising at their workplace on their own with self confidence. Conclusion: The participatory ergonomics proved effective with workers of mega kitchen, and it is a feasible and practical approach. The advantage of the given study area was that it had a sophisticated and ergonomically designed workstation; thus it was the lack of education and practical knowledge to use these stations was of utmost need. There was a significant reduction in VAS scores with the implementation of changes in the working style, and the knowledge of ergonomics helped to decrease physical load and improve musculoskeletal health.

Keywords: ergonomic awareness session, mega kitchen, participatory ergonomics, work related musculoskeletal disorders

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Authors: Ibrahim Umar, S Chindo, A Rajab

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Background: TB remains a disease of public health concern in Nigeria with an estimated incidence rate of 219/100,000. Kano has the second highest TB burden in Nigeria and is the leading state with the highest consistent yearly TB notification. House-to-house (H2H) active case search in the community was found to have major contribution to the total TB notification in the state. Aims and Objective: To showcase the impact of H2H community active TB case search (ACF) to yearly TB notification in Kano State, Northern Nigeria from 2012 to 2022. Methodology: This is a retrospective descriptive study based on the analysis of data collected during the routine quarterly and yearly TB data collected in the state. Data was analyzed using the Power BI with statistical alpha level of significance <0.05. Results: Between 2012 and 2013 there was no House-to-house active TB case search in Nigeria and Kano had zero contribution to TB notification from the community in those years. However, in 2014 with the introduction of H2H Active TB Case Search Kano notified 6,014 TB cases out of which 113 came from the community ACF that translated to 2% contribution to total TB notification. From 2014 to 2022 there was progressive increase in community contribution to TB case notification from 113 out of 6,014 total TB patients notified (2012) to 11,799 out of 26,371 TB patients notified (2022) in Kano State. This translated to 45% increase in community contribution to total TB case notification. Discussion: Remarkable increase in community contribution to total TB case notification in Kano State was achieved in 2022 with 11,799 TB cases notified from the community Active TB case search to the total of 26,731 TB cases notified in Kano State, Nigeria. Conclusion: in research has shown that Community-based H2H Active TB Case Search through Community TB Workers (CTWs) is an excellent strategy in finding the missing TB cases towards Ending TB in the world.

Keywords: tuberculosis(TB), active case search (ACF), house-to-house (H2H), community TB workers (CTWs)

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Authors: J. Santos, A. Gomes, G. Goncalves

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Organizations have increased the debate on the importance of symbolic aspects need to humanize, based on trust. A strong connection with the cultural guidance is key to determine the success of any company since it guarantees its recognition and increased productivity. This way, the quality of an organization relies essentially on its collaborators; on the way, they feel the company as their own. The changes imposed on public institutions try to fit some management practices of the private sector, to the public organizations. Currently, all efforts are aimed to increase competitiveness and promoting a better organizational performance, which leads to an increased the importance of human assets in organizations. A particular interest is the internal marketing since it has a relevant role in the development of employees. This research aimed to describe and identify how internal marketing contributes to explain organizational commitment. A quantitative analysis was done with a sample of 600 workers from public organizations, collected through a questionnaire composed of two scales that allowed the analysis of each of the constructs. The results show explanatory contribution of internal marketing practices on affective and normative commitment, through written information. By the results, workers are committed to the organizations.

Keywords: internal marketing, organizational commitment, public institutions, Portuguese

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Authors: Nomcebo N. Mpili, Cynthia Z. Madlabana

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The South African Primary Health Care (PHC) system has undergone a number of transformations such as the introduction of National Health Insurance (NHI) to bring about easily accessible universal health coverage and to meet the health needs for all its citizens. This provides ongoing challenges to ensure that health workers are equipped with appropriate knowledge, support, and skills to meet these changes. Therefore it is crucial to understand the experiences and challenges of nurses as the backbone of PHC in providing quality healthcare services. In addition there has been a need to understand nurses’ experiences with management support, role ambiguity and role conflict amongst other challenges in light of the current reforms in healthcare. Indeed these constructs are notorious for having a detrimental impact on the outcomes of change initiatives within any organisation, this is no different in healthcare. This draws a discussion on professional nurses within the South African health care system especially since they have been labelled as the backbone of PHC, meaning any healthcare backlog falls on them. The study made use of semi-structured interviews and adopted the interpretative phenomenological approach (IPA) as the researcher aimed to explore the lived experiences of (n= 18) participants. The study discovered that professional nurses experienced a lack of management support within PHC facilities and that management mainly played an administrative and disciplinary role. Although participants mainly held positive perceptions with regards to changes happening in health care however they also expressed negative experiences in terms of how change initiatives were introduced resulting in role conflict and role ambiguity. Participants mentioned a shortage of staff, inadequate training as well as a lack of management support as some of the key challenges faced in facilities. This study offers unique findings as participants have not only experienced the various reforms within the PHC system however they have also been part of NHI pilot. The authors are not aware of any other studies published that examine management support, role conflict and role ambiguity together especially in South African PHC facilities. In conclusion understanding these challenges may provide insight and opportunities available to improve the current landscape of PHC not only in South Africa but internationally.

Keywords: management support, professional nurse, role ambiguity, role conflict

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Authors: Ilham Zaidi, P. Sankara Sarma, Quazi Taufique Ahmed, V. Raman Kutty, Khalid Umer Khayyam, Gurpreet Singh, Abhishek Royal

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Introduction: Tuberculosis is a global public health emergency, but it is particularly acute in India, which has the world's highest tuberculosis burden. Due to overpopulation, lack of sanitation, malnutrition, low living standards, and poor socioeconomic status, among other factors, it is India's most common infectious disease. The long period of treatment is one of the main reasons for considering it as a public health emergency. Consequently, there is an increase in patient noncompliance, which leads to treatment failure, adverse treatment outcomes, and deaths. This could lead to the growth of anti-TB drug resistance. According to the WHO, approximately 558 thousand new cases of Multi-Drug Resistance Tuberculosis were diagnosed worldwide, with 8.5 percent developed Extensively Drug Resistance Tuberculosis. Methodology: This study is a program-based cross-sectional descriptive survey of adult tuberculosis patients enrolled in the Delhi-based Revised National Tuberculosis Program. The study setting was 27 NTEP districts of Delhi. (N=65,893) and Sample size- was 200; the sampling method which is used in the study was the systemic random sampling method. Results: Most of the demographic factors (age, gender, residence, and family type) were not significantly associated with adherence; marital status was found statistically significant with the treatment compliance. Hesitation while telling people about the disease and motivation to strictly follow drug schedule by healthcare workers were other factors where a significant association with drug adherence was observed. The study findings also suggest that provision of food, minimal financial and other moral support from family, counseling, discussion and politeness by healthcare providers might also facilitate adherence. Discussion and Conclusions: For TB treatment, adherence, age, sex, socioeconomic status, types of accommodations, malnutrition, and personal hygiene should all be considered; similar results were observed in previous studies. In the care of TB patients, DOTS services, health workers, and family support play a significant role. According to the country's National Strategic Plan, the Indian government has set a goal of eliminating tuberculosis by 2025 and patients' compliance with TB care and treatment adherence is very crucial to achieve this aim. A cohort study will be able to give a better understanding of factors associated with adherence since this study may have missed some defaulters who were absconding and could not be reached. Important Terms: RNTCP, NTEP, DOTS, DS-TB, DR-TB, RR-TB, MDR-TB, XDR-TB, Treatment failure, Treatment relapse, Treatment adherence.

Keywords: treatment adherence, treatment relapse, treatment failure, drug resistance tuberculosis

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